Hailen Matthew Ackerman
Individual provider Active NPI Behavior Technician · Fargo, ND
NPI 1154922201 · NPPES record last updated Nov 5, 2020
Key facts
- NPI
- 1154922201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614 - Phone
- (701) 478-0221
- NPI assigned
- Nov 5, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614
Mailing address
4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614
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- Sally Ackerman
- Jennifer Ackerson
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All providers in Fargo, ND · Behavior Technician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.